Photofunctionalization of dental zirconia oxide: Surface modification to improve bio-integration preserving crystal stability

The use of zirconium oxide in dental implantology is rapidly increasing as it is regarded as being more aesthetical and biologically friendly than titanium oxide. The interaction of titanium oxide with cells and proteins has proven to be significantly affected by the inevitable atmospheric hydrocarbon contamination, defined as biological ageing. The latter has proven to be effectively reversed by UVC irradiation. Crystal structures of both Zr and Ti oxides are very similar, thus also ZrO₂ is prone to contamination by hydrocarbons. In the present study we have characterized the chemical-physical changes occurring to ZrO₂ after UVC irradiation. Firstly a reduction by 3-fold of carbon present on its surface. XRD analysis has indicated that UVC irradiation treatment does not affect the crystalline structure of ZrO₂, suggesting that it is possible to improve cell attachment on the surface without sacrificing the mechanical strength of the material. In addition a chemical model of interaction of cell surface proteins with the almost carbon free ZrO₂ surface obtainable after UVC irradiation is proposed, pointing to the important role likely played by integrins and RGD sequences originating in soluble proteins adsorbed at the cell/ZrO₂ interface. Hence in clinical practice UVC photofunctionalization could improve the soft tissue seal around dental implants functioning as a valid barrier between implant and peri-implant bone, thereby improving the long-term success of implants.

Photofunctionalization of Titanium: An Alternative Explanation of Its Chemical-Physical Mechanism

Objectives

To demonstrate that titanium implant surfaces as little as 4 weeks from production are contaminated by atmospheric hydrocarbons. This phenomenon, also known as biological ageing can be reversed by UVC irradiation technically known as photofunctionalization. To propose a new model from our experimental evidence to explain how the changes in chemical structure of the surface will affect the adsorption of amino acids on the titanium surface enhancing osteointegration.

Methods

In our study XPS and AES were used to analyze the effects of UVC irradiation (photofunctionalization) in reversing biological ageing of titanium. SEM was used to analyze any possible effects on the topography of the surface.

Results

UVC irradiation was able to reverse biological ageing of titanium by greatly reducing the amount of carbon contamination present on the implant surface by up to 4 times, while the topography of the surface was not affected. UVC photon energy reduces surface H₂O and increases TiOH with many –OH groups being produced. These groups explain the super-hydrophilic effect from photofunctionalization when these groups come into contact with water.

Significance

Photofunctionalization has proven to be a valid method to reduce the amount of hydrocarbon contamination on titanium dental implants and improve biological results. The chemisorption mechanisms of amino acids, in our study, are dictated by the chemical structure and electric state present on the surface, but only in the presence of an also favourable geometrical composition at the atomical level.

Role of acoustic cavitation in the delivery and monitoring of cancer treatment by high-intensity focused ultrasound (HIFU)

Acoustic cavitation has been shown to play a key role in a wide array of novel therapeutic ultrasound applications. This paper presents a brief discussion of the physics of thermally relevant acoustic cavitation in the context of high-intensity focussed ultrasound (HIFU). Models for how different types of cavitation activity can serve to accelerate tissue heating are presented, and results suggest that the bulk of the enhanced heating effect can be attributed to the absorption of broadband acoustic emissions generated by inertial cavitation. Such emissions can be readily monitored using a passive cavitation detection (PCD) scheme and could provide a means for real-time treatment monitoring. It is also shown that the appearance of hyperechoic regions (or bright-ups) on B-mode ultrasound images constitutes neither a necessary nor a sufficient condition for inertial cavitation activity to have occurred during HIFU exposure. Once instigated at relatively large HIFU excitation amplitudes, bubble activity tends to grow unstable and to migrate toward the source transducer, causing potentially undesirable pre-focal damage. Potential means of controlling inertial cavitation activity using pulsed excitation so as to confine it to the focal region are presented, with the intention of harnessing cavitation-enhanced heating for optimal HIFU treatment delivery. The role of temperature elevation in mitigating bubble-enhanced heating effects is also discussed, along with other bubble-field effects such as multiple scattering and shielding.

Measurements of bubble-enhanced heating from focused, MHz-frequency ultrasound in a tissue-mimicking material

Time-resolved measurements of the temperature field in an agar-based tissue-mimicking phantom insonated with a large aperture 1-MHz focused acoustic transducer are reported. The acoustic pressure amplitude and insonation duration were varied. Above a critical threshold acoustic pressure, a large increase in the temperature rise during insonation was observed. Evidence for the hypothesis that cavitation bubble activity in the focal zone is the cause of enhanced heating is presented and discussed. Mechanisms for bubble-assisted heating are presented and modeled, and quantitative estimates for the thermal power generated by viscous dissipation and bubble acoustic radiation are given.

Dynamics of gas bubbles in viscoelastic fluids. II. Nonlinear viscoelasticity

The nonlinear oscillations of a spherical, acoustically forced gas bubble in nonlinear viscoelastic media are examined. The constitutive equation [Upper-Convective Maxwell (UCM)] used for the fluid is suitable for study of large-amplitude excursions of the bubble, in contrast to the previous work of the authors which focused on the smaller amplitude oscillations within a linear viscoelastic fluid [J. S. Allen and R. A. Roy, J. Acoust. Soc. Am. 107, 3167-3178 (2000)]. Assumptions concerning the trace of the stress tensor are addressed in light of the incorporation of viscoelastic constitutive equations into bubble dynamics equations. The numerical method used to solve the governing system of equations (one integrodifferential equation and two partial differential equations) is outlined. An energy balance relation is used to monitor the accuracy of the calculations and the formulation is compared with the previously developed linear viscoelastic model. Results are found to agree in the limit of small deformations; however, significant divergence for larger radial oscillations is noted. Furthermore, the inherent limitations of the linear viscoelastic approach are explored in light of the more complete nonlinear formulation. The relevance and importance of this approach to biomedical ultrasound applications are highlighted. Preliminary results indicate that tissue viscoelasticity may be an important consideration for the risk assessment of potential cavitation bioeffects.

Amplitude degradation of time-reversed pulses in nonlinear absorbing thermoviscous fluids

The linear wave equation in a lossless medium is time reversible, i.e., every solution p(x, t) has a temporal mirror solution p(x, -t). Analysis shows that time reversal also holds for the lossless nonlinear wave equation. In both cases, time-reversal invariance is violated when losses are present. For nonlinear propagation loses cannot normally be ignored; they are necessary to prevent the occurrence of multivalued waveforms. Further analysis of the nonlinear wave equation shows that amplification of a time-reversed pulse at the array elements also leads to a violation of time reversal even for lossless nonlinear acoustics. Numerical simulations are used to illustrate the effect of nonlinearity on the ability of a time-reversal system to effectively focus on a target in an absorbing fluid medium. We consider both the amplitude and arrival time of retrodirected pulses. The numerical results confirm that both shock generation (with the accompanying absorption) and amplification at the array, adversely affect the ability of a time-reversal system to form strong retrodirective sound fields.

Dynamics of gas bubbles in viscoelastic fluids. I. Linear viscoelasticity

The nonlinear oscillations of spherical gas bubbles in linear viscoelastic fluids are studied. A novel approach is implemented to derive a governing system of nonlinear ordinary differential equations. The linear Maxwell and Jeffreys models are chosen as the fluid constitutive equations. An advantage of this new formulation is that, when compared with previous approaches, it facilitates perturbation methods and numerical investigations. Analytical solutions are obtained using a multiple scale perturbation method and compared with the Newtonian results for various Deborah numbers. Numerical analysis of the full equations supports the perturbation analysis, and further reveals significant differences between the viscoelastic and Newtonian cases. Differences in the oscillation phase and harmonic structure characterize some of the viscoelastic effects. Subharmonic excitations at particular fluid parameters lead to a discrete group modulation of the radial excursions; this appears to be a unique, previously undiscovered phenomenon. Implications for medical ultrasound applications are discussed in light of these current findings.

Comparisons of sonoluminescence from single-bubbles and cavitation fields: bridging the gap

Sonoluminescence (SL) refers to the generation of light through the energetic pulsations of acoustic cavitation bubbles in a liquid. For years, SL was observed primarily in cavitation fields. These bubbles are believed by many to undergo near-adiabatic compression, resulting in the heating of the bubble contents and the subsequent emission of light. Recently, researchers have discovered a 'new' form of sonoluminescence in which light is observed to emanate from a single bubble undergoing very large volume excursions. The mechanism for light production is unknown, but many believe it is due to a rapid heating of the central core by an imploding shock wave. Based in part on the emission time scales, there is a common belief that the two forms of SL are quite distinct. We address this issue by comparing the two phenomena with regards to their light-flash durations and emission spectra--leading to some surprising differences and similarities.

Physical mechanisms governing the hydrodynamic response of an oscillating ultrasonic file

Ultrasonically driven vibrating files are known to enhance the efficiency of root canal debridement. This paper presents a phenomenological view of the hydrodynamic response of an oscillating ultrasonic file and the relationship between the file response and various physical factors such as file size and curvature, file surface properties, file velocity amplitude, root canal geometry, and the type of irrigant. Relevant hydrodynamic properties include the propensity of a file to produce stable and transient cavitation, steady streaming, and cavitation microstreaming. These relationships were explored by experiment. Sonoluminescence was employed as an indicator of transient cavitation activity and photographic analysis was utilized as a means for detecting steady streaming, microstreaming, and stable cavitation. Measurements failed to indicate any strong correlation between registered driving power and the propensity to produce transient cavitation. Files that were pitted or possessed salient edges were very effective at generating transient cavitation. When observed, transient cavitation activity generally occurred near the tip of the straight file, provided the wall-loading did not inhibit file motion. In all cases studied, steady streaming and stable cavitation were observed to varying degrees, depending on the amount of file to wall contact. Stable cavitation was probably enhanced by the addition of moderate amounts of dissolved gas into the irrigant. Although the imposition of file-wall contact served to inhibit the production of transient cavitation, this action had relatively little effect on the ability of a file to produce a nominal level of streaming, microstreaming, and stable cavitation. The relationship between these hydrodynamic properties and the process of root canal debridement is addressed. Observations suggest that it is not prudent to ascribe enhanced cleaning effects to any one phenomenon, for it is likely that several factors are involved to varying degrees depending on the local conditions of application.

Some observations on the breakage of ultrasonic files driven piezoelectrically

The incidence of breakage of Piezon-Master ultrasonic K files were evaluated. Three groups of unused files were subjected to three treatments, namely; free vibration in air without irrigation, free vibration in root canal while minimizing contact with the wall of canal in the presence of irrigation and light filing in root canal with free flow of irrigation. Cavitation produced by files in contact and free of contact with a glass surface was examined in order to observe the relationship between cavitation defects and breakage. In addition, the fractured and unfractured files were examined under a scanning electron microscope for the presence of cavitation pits. The results indicated that more files broke in air. In water, a higher incidence of breakage occurred when files were allowed to freely vibrate while no breakage occurred when the files were used in filing. All files generated cavitation which resulted in pitting of their surfaces. However, it was considered unlikely that the pits contributed to fracture. Fatigue cracks which could be the result of the manufacturing process were observed at some of the corners of the cross sections of the fractured files and could be the main contributory factor to fracture.

Variations in power output of the Piezon-Master 400 ultrasonic endodontic unit

The present study was undertaken to see if there was any variability in the power output of Piezon-Master 400 ultrasonic files when driven using different generators, tranducers and file holders. The displacement amplitude of the oscillating tip of the file in air was used as a measure of the power output. The results showed that there was considerable variability in the power output of Piezon-Master 400 ultrasonic files of similar size and length when driven using different generators, transducers and file holders. In consideration of this, it is recommended that a calibration device be incorporated in the ultrasonic unit so that the operator will have some knowledge of when the unit is working at its maximum efficiency.

The vibratory pattern of ultrasonic files driven piezoelectrically

The pattern of oscillation of a Piezon-Master 400 ultrasonic file driven by a piezoelectric transducer was studied in air and on water. In addition, the displacement amplitudes of the files were measured. The findings were compared with those observed with the Cavi-Endo unit reported in another study (Ahmad 1969). It was observed that the file vibrated such that a standing wave was formed on the file and it exhibited points of maximum deflection (antinode) and points of minimum deflection (node) with the largest deflection occurring at the apical end. This pattern of oscillation was similar to that exhibited by the Cavi-Endo file which employed a magnetostrictive transducer. However, the displacement amplitudes were very much higher than those exhibited by the Cavi-Endo. It is considered that the 120 degrees angle of the file holder inherent in the Piezon-Master 400 unit and the more effective power transmission with the piezoelectric transducer may have contributed to the large amplitudes.

Observations of acoustic streaming fields around an oscillating ultrasonic file

The steady acoustic streaming generated around straight and precurved oscillating ultrasonic files driven by the Piezon-Master 400 unit was examined in the free field and in small channels using a stereomicroscope. In addition, the effect of file-wall contact on streaming production was also investigated. The results indicated that the ultrasonic files can generate acoustic streaming both in the free field and in the small channel. Higher velocity streaming was observed when smaller size files were employed and when the file was precurved. Light file-wall contact did not totally inhibit streaming while severe file-wall contact inhibited movement of the file and, as a result, no streaming was observed. The positions and length scales of the streaming vortices appeared to be influenced by the presence of boundaries. In the free field, two rows of vortices were situated along the sides of the file while in the small channel, the vortices were positioned above the surface of the file. These results indicated that it is possible for acoustic streaming to occur in a confined space as in a root canal provided that severe file-wall contact is avoided. It is therefore recommended that light filing or allowing the file to freely vibrate during some stage of treatment should be carried out in order to generate streaming in the root canal.

In vitro detection of cavitation induced by a diagnostic ultrasound system

Experiments were performed to determine whether a clinical diagnostic scanner, a Hewlett-Packard (HP) 77020A, could produce cavitation in water containing suspensions of either 0.245-mum polystyrene spheres or Albunex, 1-10 mum albumin-coated microbubbles. Two calibrated, phased-array HP imaging transducers with 2.5- and 5.0-MHz operating frequencies were driven in M-mode (single cycle) and Doppler mode 4 cycles by the HP imaging system. Cavitation was detected in the water with polystyrene spheres at 2.5 MHz in both M-mode and Doppler mode at a peak negative acoustic pressure of 1.1 MPa or greater. Insonification at 5.0 MHz in either mode did not produce a detectable amount of cavitation, even with peak negative pressures as high as 1.2 MPa. Cavitation was not detected in water with the Albunex spheres at either frequency.

Acoustic microcavitation: its active and passive acoustic detection

In this work acoustic microcavitation in water is studied primarily at 0.75 MHz and 1% duty cycle. To detect cavitation, two kinds of acoustic detectors are used. The first one is an unfocused, untuned 1-MHz receiver transducer that serves as a passive detector. The other one is a focused 30-MHz transducer that is used in pulse-echo mode and is called the active detector. Cavitation itself is brought about by a focused PZT-8 crystal driven in pulse mode. The active detector is arranged confocally with respect to the cavitation transducer. Both the interrogating pulse and the cavitation pulse arrive simultaneously at the common focus, which is the region of cavitation. With the test chamber filled with clean water, no cavitation is observed, even when the cavitation transducer is driven to give its peak output of 22 bar peak negative. Cavitation is, however, observed when polystyrene microparticles are added to the host water. Our view of how these smooth, spherical, monodispersed microparticles give rise to cavitation is described with some estimates. An attempt has been made to understand whether the presence of "streaming" affects the thresholds, and it has been found that the active detector field affects the cavitation process.

An acoustic backscattering technique for the detection of transient cavitation produced by microsecond pulses of ultrasound

An acoustic backscattering technique for detecting transient cavitation produced by 10-microseconds-long pulses of 757-kHz ultrasound is described. The system employs 10-microseconds-long, 30-MHz center frequency tone bursts that scatter from cavitation microbubbles. Experiments were performed with suspensions of hydrophobic polystyrene spheres in ultraclean water. Transient cavitation threshold pressures measured with the active cavitation detector (ACD) were always less than or equal to those measured using a passive acoustic detection scheme. The measured cavitation thresholds decreased with increasing dissolved gas content and increasing suspended particle concentration. Results also show that ultrasonic irradiation of the polystyrene sphere suspensions by the ACD lowered the threshold pressure measured with the passive detector. A possible mechanism through which suspensions of hydrophobic particles might nucleate bubbles is presented.

Thresholds for cavitation produced in water by pulsed ultrasound

The threshold for transient cavitation produced in water by pulsed ultrasound was measured as a function of pulse duration and pulse repetition frequency at both 0.98 and 2.30 MHz. The cavitation events were detected with a passive acoustic technique which relies upon the scattering of the irradiation field by the bubble clouds associated with the events. The results indicate that the threshold is independent of pulse duration and acoustic frequency for pulses longer than approximately 10 acoustic cycles. The threshold increases for shorter pulses. The cavitation events are likely to be associated with bubble clouds rather than single bubbles.

A precise technique for the measurement of acoustic cavitation thresholds and some preliminary results

A description is given of a precise technique for measuring the threshold for acoustic cavitation inception. The system, which is automated so as to remove operator involvement, utilizes a slow ramping of the acoustic pressure amplitude until cavitation occurs. The detection criterion is the generation of a sufficiently intense sonoluminescent signal. Measurements made in filtered water show a well-defined, reproducible, and stable cavitation threshold. Measurements of the dependence of the threshold on filter size, on time, and on the concentration of dissolved ions for various salts are also presented. Many of these results appear anomalous.